A common report by surgeons in the early 19th century was ‘operation successful but the patient died’. The development of the antiseptic system by Joseph Lister, Professor of Clinical Surgery at King’s between 1877 and 1893, strikingly changed this outlook for patients. Lister’s system reduced mortality rates from major operations from around 40 per cent to less than three per cent by 1910.
March 16 marks the 150th anniversary of the publication by Lister in The Lancet, in 1867, announcing his antiseptic system for healing wounds.
New ways of preventing infection
As a surgeon at the Glasgow Royal Infirmary in the 1860s, Lister found he was losing nearly half his amputation cases to sepsis. He began to experiment with new ways of preventing infection. Discarding the popular concept of direct infection by bad air, he concentrated on Louis Pasteur’s theory that decay was caused by living organisms which entered matter and caused it to ferment.
Lister realised that these microbes had to be destroyed before they entered a wound. Hearing that spraying fields with carbolic prevented a parasite causing disease in cattle, he began to clean and dress wounds using a solution of this acid. He first successfully used his new method in 1865, and in March 1867 he reported that his wards had been clear of sepsis for nine months.
Mending a kneecap
His theories remained controversial, however. Carbolic spray was caustic to the surgeon’s and patient’s body tissues, and it was a brave decision for King’s to offer Lister a chair of clinical surgery in 1877. But almost immediately he had an opportunity to show his skills when Francis Smith fell from his cart in the Strand and fractured his kneecap. On October 26 1877 Lister carried out the first successful operation to mend a kneecap under antiseptic conditions, and Francis Smith walked out of hospital three months later.
News of Lister’s success was widely publicised and practitioners came from all over the world to see the great man operate.
This added immensely to the fame of King’s, ensuring that King’s College Hospital (still at this stage in Portugal Street, north of the Strand) remained one of the greatest surgical centres of the day.
Watch Pankaj Chandak, a Research Fellow at King’s, look back at Lister’s achievements, and how surgical techniques and technologies have developed to improve patient care.